Department of Neurosurgery, Division of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
World Neurosurg. 2021 Apr;148:e66-e73. doi: 10.1016/j.wneu.2020.12.008. Epub 2020 Dec 9.
Hydrocephalus is a disorder of cerebrospinal fluid dynamics, traditionally treated by placement of a ventricular shunt. Shunts are effective but imperfect as they fail in an unpredictable pattern, and the patient's well-being is dependent on adequate shunt function. The omnipresent threat of shunt failure along with the potential need for invasive investigations can be stressful for patients and caregivers. Our objective was to measure post-traumatic stress symptoms (PTSS) in children with hydrocephalus and their caregivers.
A cross-sectional analysis of children with hydrocephalus and their caregivers was conducted. Caregivers completed a measure of their own PTSS (the Post-Traumatic Stress Disorders Checklist for the Diagnostic and Statistical Manual of Mental Disorders-V) and resilience (the Connor Davidson Resilience Scale). Pediatric patients rated their own PTSS and resilience using the Acute Stress Checklist for Kids and Connor Davidson Resilience Scale.
Ninety-one caregivers completed the Post-Traumatic Stress Disorders Checklist for the Diagnostic and Statistical Manual of Mental Disorders-V. Mean score was 17.0 (standard deviation 15.7; median 13.0). Fourteen percent scored above 33, the threshold suggestive of a preliminary diagnosis of post-traumatic stress disorder. There was a statistically significant association between caregiver post-traumatic stress and marital status, child's race, and caregiver education. More than half (52%) of caregivers reported their child's hydrocephalus as the most significant source of their PTSS. Children did not have markedly elevated levels of PTSS. Forty-one percent of caregivers and 60% of children scored in the lowest resilience quartile compared with the general population.
Results from this study suggest that post-traumatic stress affects caregivers with hydrocephalus, yet levels of resilience for caregivers and pediatric patients are low.
脑积水是一种脑脊液动力学紊乱,传统上通过放置脑室分流器来治疗。分流器是有效的,但并不完美,因为它们会以不可预测的模式失效,而患者的健康状况取决于分流器的功能是否正常。分流器失效的普遍威胁以及对侵入性检查的潜在需求,可能会给患者和护理人员带来压力。我们的目的是测量脑积水儿童及其护理人员的创伤后应激症状(PTSS)。
对脑积水儿童及其护理人员进行了横断面分析。护理人员完成了他们自己的创伤后应激障碍症状检查表(《精神障碍诊断与统计手册第五版》的创伤后应激障碍检查表)和韧性(Connor Davidson 韧性量表)的测量。儿科患者使用儿童急性应激检查表和 Connor Davidson 韧性量表对自己的 PTSS 和韧性进行评分。
91 名护理人员完成了《精神障碍诊断与统计手册第五版》的创伤后应激障碍检查表。平均得分为 17.0(标准差 15.7;中位数 13.0)。有 14%的人得分高于 33,这表明初步诊断为创伤后应激障碍。护理人员的创伤后应激与婚姻状况、孩子的种族和护理人员的教育程度之间存在显著关联。超过一半(52%)的护理人员报告说,孩子的脑积水是他们创伤后应激症状的最主要来源。儿童的创伤后应激症状没有明显升高。与一般人群相比,41%的护理人员和 60%的儿童的韧性评分处于最低四分位数。
本研究结果表明,创伤后应激会影响脑积水患者的护理人员,但护理人员和儿科患者的韧性水平较低。